Search results for: Empathy & Resilience Based Interventions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 30013

Search results for: Empathy & Resilience Based Interventions

28693 Knowledge Creation and Diffusion Dynamics under Stable and Turbulent Environment for Organizational Performance Optimization

Authors: Jessica Gu, Yu Chen

Abstract:

Knowledge Management (KM) is undoubtable crucial to organizational value creation, learning, and adaptation. Although the rapidly growing KM domain has been fueled with full-fledged methodologies and technologies, studies on KM evolution that bridge the organizational performance and adaptation to the organizational environment are still rarely attempted. In particular, creation (or generation) and diffusion (or share/exchange) of knowledge are of the organizational primary concerns on the problem-solving perspective, however, the optimized distribution of knowledge creation and diffusion endeavors are still unknown to knowledge workers. This research proposed an agent-based model of knowledge creation and diffusion in an organization, aiming at elucidating how the intertwining knowledge flows at microscopic level lead to optimized organizational performance at macroscopic level through evolution, and exploring what exogenous interventions by the policy maker and endogenous adjustments of the knowledge workers can better cope with different environmental conditions. With the developed model, a series of simulation experiments are conducted. Both long-term steady-state and time-dependent developmental results on organizational performance, network and structure, social interaction and learning among individuals, knowledge audit and stocktaking, and the likelihood of choosing knowledge creation and diffusion by the knowledge workers are obtained. One of the interesting findings reveals a non-monotonic phenomenon on organizational performance under turbulent environment while a monotonic phenomenon on organizational performance under a stable environment. Hence, whether the environmental condition is turbulence or stable, the most suitable exogenous KM policy and endogenous knowledge creation and diffusion choice adjustments can be identified for achieving the optimized organizational performance. Additional influential variables are further discussed and future work directions are finally elaborated. The proposed agent-based model generates evidence on how knowledge worker strategically allocates efforts on knowledge creation and diffusion, how the bottom-up interactions among individuals lead to emerged structure and optimized performance, and how environmental conditions bring in challenges to the organization system. Meanwhile, it serves as a roadmap and offers great macro and long-term insights to policy makers without interrupting the real organizational operation, sacrificing huge overhead cost, or introducing undesired panic to employees.

Keywords: knowledge creation, knowledge diffusion, agent-based modeling, organizational performance, decision making evolution

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28692 Other End of the Leash: The Volunteer Handlers Perspective of Animal-Assisted Interventions

Authors: Julie A. Carberry, Victor Maddalena

Abstract:

Animal-Assisted Interventions (AAIs) have existed in various forms for centuries. In the past 30 years, there has been a dramatic increase in popularity. AAIs are now part of the lives of persons of all ages in many types of institutions. Anecdotal evidence of the benefits of AAIs have led to widespread adoption, yet there remains a lack of solid research base for support. The research question was, what are the lived experiences of AAI volunteer handlers are? An interpretive phenomenological methodology was used for this qualitative study. Data were collected from 1 - 2 hour-long semi-structured interviews and 1 observational field visit. All interviews were conducted, transcribed, and coded for themes by the principal investigator. Participants must have been an active St. John Ambulance Therapy Dog Program volunteer for a least one year. In total, 14 volunteer handlers, along with some of their dogs, were included. The St. John Ambulance is a not for profit organization that provides training and community services to Canadians. The Therapy Dog Program is 1 of the 4 nationally recognized core community service programs. The program incorporates dogs in the otherwise traditional therapeutic intervention of friendly visitation with clients. The lack of formal objectives and goals, and a trained therapist defines the program as an Animal-Assisted Activity (AAA), which is a type of AAI. Since the animals incorporated are dogs, the program is specifically a Canine-Assisted Activity (CAA), which is a type of Canine-Assisted Intervention (CAI). Six themes emerged from the analysis of the data: (a) a win-win-win situation for all parties involved – volunteer handlers, clients, and the dogs, (b) being on the other end of the leash: functions of the role of volunteer handler, (c) the importance of socialization: from spreading smiles to creating meaningful connections, (d) the role of the dog: initiating interaction and providing comfort, (e) an opportunity to feel good and destress, and (f) altruism versus personal rewards. Other insights were found regarding the program, clients, and staff. Possible implications from this research include increased organizational recruitment and retention of volunteer handlers and as well as increased support for CAAs and other CAIs that incorporate teams of volunteer handlers and their dogs. This support could, in turn, add overall support for the acceptance and broad implementation of AAIs as an alternative and or complementary non-pharmaceutical therapeutic intervention.

Keywords: animal-assisted activity, animal-assisted intervention, canine-assisted activity, canine-assisted intervention, perspective, qualitative, volunteer handler

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28691 A Study of Mental Health of Higher Secondary School Going Children in Rural Area

Authors: Tanmay L. Joshi

Abstract:

The Mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults. In urban area, many health professionals are working for the well being for younger population. There is so much of potential in rural area. However, the rural population is somehow neglected. Apart from lack of availability of basic needs like transport, electricity, telecommunication etc; the Psychological health is also overlooked in such area. There are no mental health professionals like Psychologists, counselors etc. So the researcher tries to throw some light on the mental health of Higher Secondary School going children in rural area. The current research tries to study the Mental Health (Confidence, Sociability and Neurotic Tendency) of Higher Secondary School going children. Researchers have used the tool Vyaktitva Shodhika (a personality inventory) by Dr. U. Khire (JPIP,Pune). The Sample size is 45 (N= 40, 24 boys/21 girls). The present study may provide a good support to inculcate emotional-management programs for higher secondary school going children in rural areas.

Keywords: mental health, neurotic tendency, rural area, school going children

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28690 Evaluation of the Role of Theatre for Development in Combating Climate Change in South Africa

Authors: Isaiah Phillip Smith, Sam Erevbenagie Usadolo, Pamela Theresa Tancsik

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This paper is part of ongoing doctoral research that examines the role of Theatre for Development (TfD) in addressing climate change in the Mosuthu community in Reservoir Hills, Durban, South Africa. The context of the research underscores the pressing challenges facing South Africa, including drought, water shortages, deterioration of land, and civil unrest that require innovative approaches to the mitigation of climate change. TfD, described as a dialogical form of theatre that allows communities to express and contribute to development, emerges as a strategic medium for engaging communities in the process. The research problem focused on the unexamined potential of TfD in promoting community involvement and critical awareness of climate change. The study objectives included assessing the community's understanding of climate change, exploring TfD's potential as a participatory tool, examining its role in community mobilization, and developing recommendations for its effective implementation. A review of relevant literature and preliminary investigations in the research community indicates that TfD is an effective medium for promoting societal transformation and engaging marginalized communities. Through culturally resonant narratives, TfD can instill a deeper understanding of environmental challenges, fostering empathy and motivating behavioural changes. By integrating community voices and cultural elements, TfD serves as a powerful catalyst for promoting climate change awareness and inspiring collective action within the South African context. This research contributes to the global discourse on innovative approaches to climate change awareness and action.

Keywords: TfD, climate change, community involvement, societal transformation, culture

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28689 The Impact of a Simulated Teaching Intervention on Preservice Teachers’ Sense of Professional Identity

Authors: Jade V. Rushby, Tony Loughland, Tracy L. Durksen, Hoa Nguyen, Robert M. Klassen

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This paper reports a study investigating the development and implementation of an online multi-session ‘scenario-based learning’ (SBL) program administered to preservice teachers in Australia. The transition from initial teacher education to the teaching profession can present numerous cognitive and psychological challenges for early career teachers. Therefore, the identification of additional supports, such as scenario-based learning, that can supplement existing teacher education programs may help preservice teachers to feel more confident and prepared for the realities and complexities of teaching. Scenario-based learning is grounded in situated learning theory which holds that learning is most powerful when it is embedded within its authentic context. SBL exposes participants to complex and realistic workplace situations in a supportive environment and has been used extensively to help prepare students in other professions, such as legal and medical education. However, comparatively limited attention has been paid to investigating the effects of SBL in teacher education. In the present study, the SBL intervention provided participants with the opportunity to virtually engage with school-based scenarios, reflect on how they might respond to a series of plausible response options, and receive real-time feedback from experienced educators. The development process involved several stages, including collaboration with experienced educators to determine the scenario content based on ‘critical incidents’ they had encountered during their teaching careers, the establishment of the scoring key, the development of the expert feedback, and an extensive review process to refine the program content. The 4-part SBL program focused on areas that can be challenging in the beginning stages of a teaching career, including managing student behaviour and workload, differentiating the curriculum, and building relationships with colleagues, parents, and the community. Results from prior studies implemented by the research group using a similar 4-part format have shown a statistically significant increase in preservice teachers’ self-efficacy and classroom readiness from the pre-test to the final post-test. In the current research, professional teaching identity - incorporating self-efficacy, motivation, self-image, satisfaction, and commitment to teaching - was measured over six weeks at multiple time points: before, during, and after the 4-part scenario-based learning program. Analyses included latent growth curve modelling to assess the trajectory of change in the outcome variables throughout the intervention. The paper outlines (1) the theoretical underpinnings of SBL, (2) the development of the SBL program and methodology, and (3) the results from the study, including the impact of the SBL program on aspects of participating preservice teachers’ professional identity. The study shows how SBL interventions can be implemented alongside the initial teacher education curriculum to help prepare preservice teachers for the transition from student to teacher.

Keywords: classroom simulations, e-learning, initial teacher education, preservice teachers, professional learning, professional teaching identity, scenario-based learning, teacher development

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28688 Coupling of Reticular and Fuzzy Set Modelling in the Analysis of the Action Chains from Socio-Ecosystem, Case of the Renewable Natural Resources Management in Madagascar

Authors: Thierry Ganomanana, Dominique Hervé, Solo Randriamahaleo

Abstract:

Management of Malagasy renewable natural re-sources allows, in the case of forest, the mobilization of several actors with norms and/or territory. The interaction in this socio-ecosystem is represented by a graph of two different relationships in which most of action chains, from individual activities under the continuous of forest dynamic and discrete interventions by institutional, are also studied. The fuzzy set theory is adapted to graduate the elements of the set Illegal Activities in the space of sanction’s institution by his severity and in the space of degradation of forest by his extent.

Keywords: fuzzy set, graph, institution, renewable resource, system

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28687 Road Accident Blackspot Analysis: Development of Decision Criteria for Accident Blackspot Safety Strategies

Authors: Tania Viju, Bimal P., Naseer M. A.

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This study aims to develop a conceptual framework for the decision support system (DSS), that helps the decision-makers to dynamically choose appropriate safety measures for each identified accident blackspot. An accident blackspot is a segment of road where the frequency of accident occurrence is disproportionately greater than other sections on roadways. According to a report by the World Bank, India accounts for the highest, that is, eleven percent of the global death in road accidents with just one percent of the world’s vehicles. Hence in 2015, the Ministry of Road Transport and Highways of India gave prime importance to the rectification of accident blackspots. To enhance road traffic safety and reduce the traffic accident rate, effectively identifying and rectifying accident blackspots is of great importance. This study helps to understand and evaluate the existing methods in accident blackspot identification and prediction that are used around the world and their application in Indian roadways. The decision support system, with the help of IoT, ICT and smart systems, acts as a management and planning tool for the government for employing efficient and cost-effective rectification strategies. In order to develop a decision criterion, several factors in terms of quantitative as well as qualitative data that influence the safety conditions of the road are analyzed. Factors include past accident severity data, occurrence time, light, weather and road conditions, visibility, driver conditions, junction type, land use, road markings and signs, road geometry, etc. The framework conceptualizes decision-making by classifying blackspot stretches based on factors like accident occurrence time, different climatic and road conditions and suggesting mitigation measures based on these identified factors. The decision support system will help the public administration dynamically manage and plan the necessary safety interventions required to enhance the safety of the road network.

Keywords: decision support system, dynamic management, road accident blackspots, road safety

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28686 Glycosaminoglycan, a Cartilage Erosion Marker in Synovial Fluid of Osteoarthritis Patients Strongly Correlates with WOMAC Function Subscale

Authors: Priya Kulkarni, Soumya Koppikar, Narendrakumar Wagh, Dhanshri Ingle, Onkar Lande, Abhay Harsulkar

Abstract:

Cartilage is an extracellular matrix composed of aggrecan, which imparts it with a great tensile strength, stiffness and resilience. Disruption in cartilage metabolism leading to progressive degeneration is a characteristic feature of Osteoarthritis (OA). The process involves enzymatic depolymerisation of cartilage specific proteoglycan, releasing free glycosaminoglycan (GAG). This released GAG in synovial fluid (SF) of knee joint serves as a direct measure of cartilage loss, however, limited due to its invasive nature. Western Ontario and McMaster Universities Arthritis Index (WOMAC) is widely used for assessing pain, stiffness and physical-functions in OA patients. The scale is comprised of three subscales namely, pain, stiffness and physical-function, intends to measure patient’s perspective of disease severity as well as efficacy of prescribed treatment. Twenty SF samples obtained from OA patients were analysed for their GAG values in SF using DMMB based assay. LK 1.0 vernacular version was used to attain WOMAC scale. The results were evaluated using SAS University software (Edition 1.0) for statistical significance. All OA patients revealed higher GAG values compared to the control value of 78.4±30.1µg/ml (obtained from our non-OA patients). Average WOMAC calculated was 51.3 while pain, stiffness and function estimated were 9.7, 3.9 and 37.7, respectively. Interestingly, a strong statistical correlation was established between WOMAC function subscale and GAG (p = 0.0102). This subscale is based on day-to-day activities like stair-use, bending, walking, getting in/out of car, rising from bed. However, pain and stiffness subscale did not show correlation with any of the studied markers and endorsed the atypical inflammation in OA pathology. On one side, where knee pain showed poor correlation with GAG, it is often noted that radiography is insensitive to cartilage degenerative changes; thus OA remains undiagnosed for long. Moreover, active cartilage degradation phase remains elusive to both, patient and clinician. Through analysis of large number of OA patients we have established a close association of Kellgren-Lawrence grades and increased cartilage loss. A direct attempt to correlate WOMAC and radiographic progression of OA with various biomarkers has not been attempted so far. We found a good correlation in GAG levels in SF and the function subscale.

Keywords: cartilage, Glycosaminoglycan, synovial fluid, western ontario and McMaster Universities Arthritis Index

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28685 Lessons from Seven Years of Teaching Mindfulness to Children Living in a Context of Vulnerability

Authors: Annie Devault

Abstract:

Mindfulness-based interventions (MBI) can be beneficial for the well-being of children. MBIs offered for children in contexts of vulnerability (poverty, neglect) report positive results in terms of emotion regulation and cognitive flexibility. Anxiety is a common issue for children living in a vulnerable context. It has a negative impact on children’s attention span, emotional regulation and self-esteem. The MBI (12 weeks) associated with this research has been developed for a total of 30 children suffering from anxiety (7 to 9 years old) and receiving services from a community center over the last seven years. The first objective is to describe in details the content of the mindfulness-based intervention. The second purpose is to document what helps and what hinders the practice of mindfulness for children living in a context of vulnerability. A special attention will be given to the importance of the way that the intervention is offered and the principles that are followed by the practitioners. Perceived effects of the intervention on children were collected through an individual semi-structured interview with each child at the end of the program. Parents were also interviewed to have their point of view on the effect of their children’s participation in the group. Anxiety was measure with the Beck youth pre-post and at follow up (2 months). Qualitative analysis of the interviews with children showed that most of them mentioned that the program helped them become calmer, more confident, less scared and more able to deal with difficult emotions. Almost all of them reported having used the material provided to them to practice at home. This result has been confirmed by parents. They reported that their child had gained confidence and were better at verbalizing emotions. Children also grew calmer, even though all anxiety was not gone. They would have liked more material to practice at home. The quantitative instrument used to measure anxiety did not corroborate the qualitative interviews about anxiety. Discussion will question the use of this questionnaire for children who have important cognitive limitations. Discussion will also report the importance of the personalized contact with children, along with other consideration, to enhance the adherence of children and parents. The MBI seems to have benefited children in different ways, which is corroborated by most parents. Since the sample was limited, we will need to continue documenting its effects with more children and parents. The major strength of this research is to have reported the subjective perspectives of children on their experience of mindfulness.

Keywords: anxiety, mindfulness, children, best practices

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28684 Crosslinked Porous 3-Dimensional Cellulose Nanofibers/Gelatin Based Biocomposite Aerogels for Tissue Engineering Application

Authors: Ali Mirtaghavi, Andy Baldwin, Rajendarn Muthuraj, Jack Luo

Abstract:

Recent advances in biomaterials have led to utilizing biopolymers to develop 3D scaffolds in tissue regeneration. One of the major challenges of designing biomaterials for 3D scaffolds is to mimic the building blocks similar to the extracellular matrix (ECM) of the native tissues. Biopolymer based aerogels obtained by freeze-drying have shown to provide structural similarities to the ECM owing to their 3D format and a highly porous structure with interconnected pores, similar to the ECM. Gelatin (GEL) is known to be a promising biomaterial with inherent regenerative characteristics owing to its chemical similarities to the ECM in native tissue, biocompatibility abundance, cost-effectiveness and accessible functional groups, which makes it facile for chemical modifications with other biomaterials to form biocomposites. Despite such advantages, gelatin offers poor mechanical properties, sensitive enzymatic degradation and high viscosity at room temperature which limits its application and encourages its use to develop biocomposites. Hydrophilic biomass-based cellulose nanofibrous (CNF) has been explored to use as suspension for biocomposite aerogels for the development of 3D porous structures with excellent mechanical properties, biocompatibility and slow enzymatic degradation. In this work, CNF biocomposite aerogels with various ratios of CNF:GEL) (90:10, 70:30 and 50:50) were prepared by freeze-drying technique, and their properties were investigated in terms of physicochemical, mechanical and biological characteristics. Epichlorohydrin (EPH) was used to investigate the effect of chemical crosslinking on the molecular interaction of CNF: GEL, and its effects on physicochemical, mechanical and biological properties of the biocomposite aerogels. Ultimately, chemical crosslinking helped to improve the mechanical resilience of the resulting aerogels. Amongst all the CNF-GEL composites, the crosslinked CNF: GEL (70:30) biocomposite was found to be favourable for cell attachment and viability. It possessed highly porous structure (porosity of ~93%) with pore sizes ranging from 16-110 µm, adequate mechanical properties (compression modulus of ~47 kPa) and optimal biocompatibility both in-vitro and in-vivo, as well as controlled enzymatic biodegradation, high water penetration, which could be considered a suitable option for wound healing application. In-vivo experiments showed improvement on inflammation and foreign giant body cell reaction for the crosslinked CNF: GEL (70:30) compared to the other samples. This could be due to the superior interaction of CNF with gelatin through chemical crosslinking, resulting in more optimal in-vivo improvement. In-vitro cell culture investigation on human dermal fibroblasts showed satisfactory 3D cell attachment over time. Overall, it has been observed that the developed CNF: GEL aerogel can be considered as a potential scaffold for soft tissue regeneration application.

Keywords: 3D scaffolds, aerogels, Biocomposites , tissue engineering

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28683 Emerging Threats and Adaptive Defenses: Navigating the Future of Cybersecurity in a Hyperconnected World

Authors: Olasunkanmi Jame Ayodeji, Adebayo Adeyinka Victor

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In a hyperconnected world, cybersecurity faces a continuous evolution of threats that challenge traditional defence mechanisms. This paper explores emerging cybersecurity threats like malware, ransomware, phishing, social engineering, and the Internet of Things (IoT) vulnerabilities. It delves into the inadequacies of existing cybersecurity defences in addressing these evolving risks and advocates for adaptive defence mechanisms that leverage AI, machine learning, and zero-trust architectures. The paper proposes collaborative approaches, including public-private partnerships and information sharing, as essential to building a robust defence strategy to address future cyber threats. The need for continuous monitoring, real-time incident response, and adaptive resilience strategies is highlighted to fortify digital infrastructures in the face of escalating global cyber risks.

Keywords: cybersecurity, hyperconnectivity, malware, adaptive defences, zero-trust architecture, internet of things vulnerabilities

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28682 Creating a Dementia-Friendly Community

Authors: Annika Kjallman Alm, Ove Hellzen, Malin Rising-Homlstrom

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The concept of dementia‐friendly communities focuses on the lived experience of people who have dementia and is most relevant to addressing their needs and the needs of those people who live with and provide support for them. The goal of communities becoming dementia‐friendly is for dementia to be normalized and recognized as a disabling condition. People with dementia find being connected to self, to others, and to the environment by meaningful activities as important. According to the concept underlying dementia-friendly communities, people with dementia or cognitive decline can continue to live in the community if their residential community has sufficiently strong social capital. The aim of this study is to explore staff and leaders’ experiences in implementing interventions to enhance a more inclusive dementia-friendly community. A municipality in northern Sweden with a population of approx. 100 000 inhabitants decided to create a dementia friendly municipality. As part of the initiative, a Centre for support was established. The Centre offered support for both individuals and groups, did home visits, and provided information about Dementia. Interviews were conducted with staff who had undergone training in a structured form of multidimensional support, the PER-model®, and worked at the Centre for support. The staff consisted of registered nurses, occupational therapists, and specialized nurses who had worked there for more than five years, and all had training in dementia. All interviews were audio-recorded and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results suggest that implementing the PER-model® of support for persons in the early stages of dementia and their next of kin added a much-needed form of support and perceived possibilities to enhance daily life in the early stages of dementia. The staff appreciated that the structure of PER-model® was evidenced based. They also realized that they never even considered that the person with dementia also needed support in the early stages but that they now had tools for that as well. Creating a dementia friendly municipality offering different kinds of support for all stages of dementia is a challenge. However, evidence-based tools and a broad spectrum of different types of support, whether individual or group, are needed to tailor to everyone’s needs. A conviction that all citizens are equal and should all be involved in the community is a strong motivator.

Keywords: dementia, dementia-friendly, municipality, support

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28681 Global Culture Museums: Bridging Societies, Fostering Understanding, and Preserving Heritage

Authors: Hossam Hegazi

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Global culture museums play a pivotal role in fostering cross-cultural connections, enhancing mutual understanding, and safeguarding the rich tapestry of cultural heritage. These institutions serve as dynamic bridges, facilitating the exchange of ideas and values among diverse societies. One of the primary functions of global culture museums is to connect people from different backgrounds. By showcasing the artistic expressions, traditions, and historical artifacts of various civilizations, these museums create a shared space for dialogue. Visitors are afforded the opportunity to explore and appreciate the nuances of cultures different from their own, promoting a sense of global interconnectedness. Moreover, these museums contribute significantly to mutual understanding. Through interactive exhibits, innovative technologies, and educational programs, they offer immersive experiences that transcend linguistic and geographical barriers. Visitors gain insights into the customs, beliefs, and lifestyles of others, fostering empathy and appreciation for cultural diversity. Preserving cultural heritage stands as another key objective of global culture museums. By housing and curating artifacts, artworks, and historical items, these institutions play a crucial role in safeguarding the collective memory of humanity. This preservation effort ensures that future generations have access to the cultural legacies that have shaped societies across the globe. In conclusion, global culture museums serve as dynamic hubs that bring people together, promote understanding, and safeguard the wealth of human cultural heritage. Their impact extends beyond the walls of exhibition halls, contributing to a more interconnected and culturally enriched world.

Keywords: global culture museums, cross-cultural connections, mutual understanding, societal dialogue

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28680 Occupant Behaviour Change in Post-Pandemic Australia

Authors: Yan Zhang, Felix Kin Peng Hui, Colin Duffield, Caroline X. Gao

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In post-pandemic Australia, it is unclear how building occupant have changed their behaviour in their interaction with buildings and other occupants. This research provides information on occupant behaviour change compared to before the pandemic and examines the predictors for those behaviour changes. This paper analyses survey responses from 2298 building occupants in Melbourne to investigate occupant behaviour change and determinants for those changes one year after the pandemic in Australia. The behaviour changes were grouped into three categories based on respiratory infection routes: (1) fomite: hand-shaking and hand hygiene behaviours; (2) airborne: individual interventions to indoor air quality such as face masking, window openings for occupants working in naturally ventilated space; (3) droplets: social distancing, reducing working hours in the workplace. The survey shows that the pandemic has significantly changed occupants' behaviour in all three categories compared to before the pandemic. The changes are significantly associated with occupants' perceived indoor air quality, indoor environmental cleanliness, and occupant density, demonstrating their growing awareness of respiratory infection risk that influences their health behaviours. The two most significant factors identified from multivariate regressions to drive the behaviour change include occupant risk perception of respiratory infections at the workplace and their observed co-worker's behaviour change. Based on the survey results, the paper provides adjusted estimates for related occupant behaviour parameters. The study also discusses alternatives for managing window operations in naturally ventilated buildings to improve occupant satisfaction. This paper could help Building Managers, and Building Designers understand occupant behaviour change to improve building operations and new building design to enhance occupant experience. Also, building energy modellers and risk assessors may use the findings to adjust occupant behaviour-related parameters to improve the models. The findings contribute to the knowledge of Human-Building Interaction.

Keywords: human-building interaction, risk perception, occupant behaviour, IAQ, COVID-19

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28679 Institutional Effectiveness in Fostering Student Retention and Success in First Year

Authors: Naziema B. Jappie

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The objective of this study is to examine the relationship between college readiness characteristics and learning outcome assessment scores. About this, it is important to examine the first-year retention and success rate. In order to undertake this study, it will be necessary to look at proficiency levels on general and domain-specific knowledge and skills reflected on national benchmark test scores (NBT), in-college interventions and course-taking patterns. Preliminary results based on data from more than 1000 students suggest that there is a positive association between NBT scores and students’ 1st-year college GPA and their retention status. For example, 63% of students with a proficient level of math skills in the NBT had the highest level of GPA at the end of 1st-year of college in comparison to 56% of those who started with a primary or intermediate level, respectively. The retention rates among those with proficiency levels were also higher than those with basic or intermediate levels (98% vs. 93% and 88%, respectively). By the end of 3rd year in college, students with intermediate or proficient entering NBT math skills had 7% and 8% of dropout rate, compared to 14% for those started at primary level; a greater percentage of students qualified by the end of 3rd-year qualified among proficient students than that among intermediate or basic level students (50% vs. 44% and 27% respectively). The findings of this study added knowledge to the field in South Africa and are expected to help stakeholders and policymakers to better understand college learning and challenges for students with disadvantaged backgrounds and provide empirical evidence in support of related practices and policies.

Keywords: assessment, data analysis, performance, proficiency, policy, student success

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28678 Natural Gas Production Forecasts Using Diffusion Models

Authors: Md. Abud Darda

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Different options for natural gas production in wide geographic areas may be described through diffusion of innovation models. This type of modeling approach provides an indirect estimate of an ultimately recoverable resource, URR, capture the quantitative effects of observed strategic interventions, and allow ex-ante assessments of future scenarios over time. In order to ensure a sustainable energy policy, it is important to forecast the availability of this natural resource. Considering a finite life cycle, in this paper we try to investigate the natural gas production of Myanmar and Algeria, two important natural gas provider in the world energy market. A number of homogeneous and heterogeneous diffusion models, with convenient extensions, have been used. Models validation has also been performed in terms of prediction capability.

Keywords: diffusion models, energy forecast, natural gas, nonlinear production

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28677 A Primary Care Diagnosis of Middle-Aged Men with Oral Cancer Who Underwent Extensive Resection and Flap Repair: A Case Report

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

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This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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28676 Investigating the Relationship between Iranian EFL Teachers' Motivation, Creativity and Job Stress

Authors: Mehrab Karimian

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This study investigates the intricate relationships among Iranian EFL teachers’ motivation, creativity, and job stress in Shiraz and Fasa institutes. The primary aim is to explore these links using quantitative methods, providing a comprehensive understanding of how these factors interact within the educational context. The research employed convenient sampling, gathering data from 101 EFL teachers through three specific questionnaires: the Motivation to Teach Questionnaire, Teacher Creativity Questionnaire, and Job Stress Questionnaire. The methodology involved rigorous statistical analyses, including Pearson correlation and multiple regression, to interpret the collected data. The findings revealed positive relationships between motivation and creativity, as well as between motivation and job stress. However, no significant link was observed between creativity and job stress. Notably, creativity emerged as a strong predictor of motivation, highlighting its crucial role in the motivational dynamics of EFL teachers. The theoretical importance of this study lies in its contribution to understanding how motivation can influence both creativity and job stress among EFL teachers. By emphasizing the complex interplay of these factors, the study provides valuable insights that can inform future research and educational practices. The data collection process was thorough, utilizing well-established questionnaires to ensure the reliability and validity of the findings. Statistical analyses such as Pearson correlation and multiple regression were employed to interpret the relationships between motivation, creativity, and job stress. These analyses provided a detailed understanding of how these variables interact, offering a nuanced view of the motivational and stress dynamics in the teaching profession. The study addressed key questions regarding the influence of motivation on creativity and job stress, underscoring the predictive power of creativity on motivation. The conclusion drawn from the study suggests that motivated EFL teachers may experience higher levels of job stress. This finding highlights the need for targeted interventions to support teacher well-being and maintain their motivation. Such interventions could include professional development programs, stress management workshops, and creative teaching strategies to help teachers manage stress while fostering their motivation and creativity. Reviewers have commended the study for its contribution to the field, particularly in revealing the intricate dynamics between motivation, creativity, and job stress in EFL teachers. They recommend enhancing the methodology by considering potential confounding variables and incorporating qualitative approaches to complement the quantitative findings. These suggestions aim to provide a more comprehensive understanding of the factors influencing EFL teachers’ motivation, creativity, and job stress.

Keywords: creativity, Job stress, gender, years of teaching experience

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28675 Predicting the Quality of Life on the Basis of Perceived Social Support among Patients with Coronary Artery Bypass Graft

Authors: Azadeh Yaraghchi, Reza Bagherian Sararoodi, Niknaz Salehi Moghadam, Mohammad Hossein Mandegar, Adis Kraskian Mujembari, Omid Rezaei

Abstract:

Background: Quality of life is one of the most important consequences of disease in psychosomatic disorders. Many psychological factors are considered in predicting quality of life in patients with coronary artery bypass graft (CABG). The present study was aimed to determine the relationship between perceived social support and quality of life in patients with coronary artery bypass graft (CABG). Methods: The population included 82 patients who had undergone CABG from October 2014 to May 2015 in four different hospitals in Tehran. The patients were evaluated with Multi-dimension scale of perceived social support (MSPSS) and after three months follow up were evaluated by Short-Form quality of life questionnaire (SF-36). The obtained data were analyzed through Pearson correlation test and multiple variable regression models. Findings: A relationship between perceived social support and quality of life in patients with CABG was observed (r=0.374, p<0.01). The results showed that 22.4% of variation in quality of life is predicted by perceived social support components (p<0.01, R2 =0.224). Conclusion: Based on the results, perceived social support is one of the predictors of quality of life in patients with coronary artery bypass graft. Accordingly, these results can be useful in conceiving proactive policies, detecting high risk patients and planning for psychological interventions.

Keywords: coronary artery bypass graft, perceived social support, psychological factors, quality of life

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28674 Parametric Urbanism: A Climate Responsive Urban Form for the MENA Region

Authors: Norhan El Dallal

Abstract:

The MENA region is a challenging, rapid urbanizing region, with a special profile; culturally, socially, economically and environmentally. Despite the diversity between different countries of the MENA region they all share similar urban challenges where extensive interventions are crucial. A climate sensitive region as the MENA region requires special attention for development, adaptation and mitigation. Integrating climatic and environmental parameters into the planning process to create a responsive urban form is the aim of this research in which “Parametric Urbanism” as a trend serves as a tool to reach a more sustainable urban morphology. An attempt to parameterize the relation between the climate and the urban form in a detailed manner is the main objective of the thesis. The aim is relating the different passive approaches suitable for the MENA region with the design guidelines of each and every part of the planning phase. Various conceptual scenarios for the network pattern and block subdivision generation based on computational models are the next steps after the parameterization. These theoretical models could be applied on different climatic zones of the dense communities of the MENA region to achieve an energy efficient neighborhood or city with respect to the urban form, morphology, and urban planning pattern. A final criticism of the theoretical model is to be conducted showing the feasibility of the proposed solutions economically. Finally some push and pull policies are to be proposed to help integrate these solutions into the planning process.

Keywords: parametric urbanism, climate responsive, urban form, urban and regional studies

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28673 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana

Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

Abstract:

Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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28672 HydroParks: Directives for Physical Environment Interventions Battling Childhood Overweight in Berlin, Germany

Authors: Alvaro Valera Sosa

Abstract:

Background: In recent years, childhood overweight and obesity have become an increasing and challenging phenomenon in Berlin and Germany in general. The highest shares of childhood overweight in Berlin are district localities within the inner city ring with lowest socio-economic levels and the highest number of migration background populations. Most factors explaining overweight and obesity are linked to individual dispositions and nutrition balances. Among various strategies, to target drinking behaviors of children and adolescents has been proven to be effective. On the one hand, encouraging the intake of water – which does not contain energy and thus may support a healthy weight status – on the other hand, reducing the consumption of sugar-containing beverages – which are linked to weight gain and obesity. Anyhow, these preventive approaches have mostly developed into individual or educational interventions widely neglecting environmental modifications. Therefore, little is known on how urban physical environment patterns and features can act as influence factors for childhood overweight. Aiming the development of a physical environment intervention tackling children overweight, this study evaluated urban situations surrounding public playgrounds in Berlin where the issue is evident. It verified the presence and state of physical environmental conditions that can be conducive for children to engage physical activity and water intake. Methods: The study included public playgrounds for children from 0-12 y/o within district localities with the highest prevalence of childhood overweight, highest population density, and highest mixed uses. A systematic observation was realized to describe physical environment patterns and features that may affect children health behavior leading to overweight. Neighborhood walkability for all age groups was assessed using the Walkability for Health framework (TU-Berlin). Playground physical environment conditions were evaluated using Active Living Research assessment sheets. Finally, the food environment in the playground’s pedestrian catchment areas was reviewed focusing on: proximity to suppliers offering sugar-containing beverages, and physical access for 5 y/o children and up to drinking water following the Drinking Fountains and Public Health guidelines of the Pacific Institute. Findings: Out of 114 locations, only 7 had a child population over 3.000. Three with the lowest socio-economic index and highest percentage of migration background were selected. All three urban situations presented similar walkability: large trafficked avenues without buffer bordering at least one side of the playground, and important block to block disconnections for active travel. All three playgrounds rated equipment conditions from good to very good. None had water fountains at the reach of a 5 y/o. and all presented convenience stores and/or fast food outlets selling sugar-containing beverages nearby the perimeter. Conclusion: The three playground situations selected are representative of Berlin locations where most factors that influence children overweight are found. The results delivered urban and architectural design directives for an environmental intervention, used to study children health-related behavior. A post-intervention evaluation could prove associations between designed spaces and children overweight rate reduction creating a precedent in public health interventions and providing novel strategies for the health sector.

Keywords: children overweight, evaluation research, public playgrounds, urban design, urban health

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28671 Circular Economy: An Overview of Principles, Strategies, and Case Studies

Authors: Dina Mohamed Ahmed Mahmoud Bakr

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The concept of a circular economy is gaining increasing attention as a way to promote sustainable economic growth and reduce the environmental impact of human activities. The circular economy is a systemic approach that aims to keep materials and resources in use for as long as possible, minimize waste and pollution, and regenerate natural systems. The purpose of this article is to present a summary of the principles and tactics employed in the circular economy, along with examples of prosperous circular economy projects implemented in different sectors across Japan, Austria, the Netherlands, South Africa, Germany, and the United States. The paper concludes with a discussion of the challenges and opportunities associated with the transition to a circular economy and the policy interventions that can support this transition.

Keywords: circular economy, waste reduction, sustainable development, recycling

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28670 Effectiveness of an Intervention to Increase Physics Students' STEM Self-Efficacy: Results of a Quasi-Experimental Study

Authors: Stephanie J. Sedberry, William J. Gerace, Ian D. Beatty, Michael J. Kane

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Increasing the number of US university students who attain degrees in STEM and enter the STEM workforce is a national priority. Demographic groups vary in their rates of participation in STEM, and the US produces just 10% of the world’s science and engineering degrees (2014 figures). To address these gaps, we have developed and tested a practical, 30-minute, single-session classroom-based intervention to improve students’ self-efficacy and academic performance in University STEM courses. Self-efficacy is a psychosocial construct that strongly correlates with academic success. Self-efficacy is a construct that is internal and relates to the social, emotional, and psychological aspects of student motivation and performance. A compelling body of research demonstrates that university students’ self-efficacy beliefs are strongly related to their selection of STEM as a major, aspirations for STEM-related careers, and persistence in science. The development of an intervention to increase students’ self-efficacy is motivated by research showing that short, social-psychological interventions in education can lead to large gains in student achievement. Our intervention addresses STEM self-efficacy via two strong, but previously separate, lines of research into attitudinal/affect variables that influence student success. The first is ‘attributional retraining,’ in which students learn to attribute their successes and failures to internal rather than external factors. The second is ‘mindset’ about fixed vs. growable intelligence, in which students learn that the brain remains plastic throughout life and that they can, with conscious effort and attention to thinking skills and strategies, become smarter. Extant interventions for both of these constructs have significantly increased academic performance in the classroom. We developed a 34-item questionnaire (Likert scale) to measure STEM Self-efficacy, Perceived Academic Control, and Growth Mindset in a University STEM context, and validated it with exploratory factor analysis, Rasch analysis, and multi-trait multi-method comparison to coded interviews. Four iterations of our 42-week research protocol were conducted across two academic years (2017-2018) at three different Universities in North Carolina, USA (UNC-G, NC A&T SU, and NCSU) with varied student demographics. We utilized a quasi-experimental prospective multiple-group time series research design with both experimental and control groups, and we are employing linear modeling to estimate the impact of the intervention on Self-Efficacy,wth-Mindset, Perceived Academic Control, and final course grades (performance measure). Preliminary results indicate statistically significant effects of treatment vs. control on Self-Efficacy, Growth-Mindset, Perceived Academic Control. Analyses are ongoing and final results pending. This intervention may have the potential to increase student success in the STEM classroom—and ownership of that success—to continue in a STEM career. Additionally, we have learned a great deal about the complex components and dynamics of self-efficacy, their link to performance, and the ways they can be impacted to improve students’ academic performance.

Keywords: academic performance, affect variables, growth mindset, intervention, perceived academic control, psycho-social variables, self-efficacy, STEM, university classrooms

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28669 Investigation of Resilient Circles in Local Community and Industry: Waju-Traditional Culture in Japan and Modern Technology Application

Authors: R. Ueda

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Today global society is seeking resilient partnership in local organizations and individuals, which realizes multi-stakeholders relationship. Although it is proposed by modern global framework of sustainable development, it is conceivable that such affiliation can be found out in the traditional local community in Japan, and that traditional spirit is tacitly sustaining in modern context of disaster mitigation in society and economy. Then this research is aiming to clarify and analyze implication for the global world by actual case studies. Regional and urban resilience is the ability of multi-stakeholders to cooperate flexibly and to adapt in response to changes in the circumstances caused by disasters, but there are various conflicts affecting coordination of disaster relief measures. These conflicts arise not only from a lack of communication and an insufficient network, but also from the difficulty to jointly draw common context from fragmented information. This is because of the weakness of our modern engineering which focuses on maintenance and restoration of individual systems. Here local ‘circles’ holistically includes local community and interacts periodically. Focusing on examples of resilient organizations and wisdom created in communities, what can be seen throughout history is a virtuous cycle where the information and the knowledge are structured, the context to be adapted becomes clear, and an adaptation at a higher level is made possible, by which the collaboration between organizations is deepened and expanded. And the wisdom of a solid and autonomous disaster prevention formed by the historical community called’ Waju’ – an area surrounded by circle embankment to protect the settlement from flood – lives on in government efforts of the coastal industrial island of today. Industrial company there collaborates to create a circle including common evacuation space, road access improvement and infrastructure recovery. These days, people here adopts new interface technology. Large-scale AR- Augmented Reality for more than hundred people is expressing detailed hazard by tsunami and liquefaction. Common experiences of the major disaster space and circle of mutual discussion are enforcing resilience. Collaboration spirit lies in the center of circle. A consistent key point is a virtuous cycle where the information and the knowledge are structured, the context to be adapted becomes clear, and an adaptation at a higher level is made possible, by which the collaboration between organizations is deepened and expanded. This writer believes that both self-governing human organizations and the societal implementation of technical systems are necessary. Infrastructure should be autonomously instituted by associations of companies and other entities in industrial areas for working closely with local governments. To develop advanced disaster prevention and multi-stakeholder collaboration, partnerships among industry, government, academia and citizens are important.

Keywords: industrial recovery, multi-sakeholders, traditional culture, user experience, Waju

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28668 Effect of Early Therapeutic Intervention for the Children With Autism Spectrum Disorders: A Quasi Experimental Design

Authors: Sultana Razia

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The number of children whose social, communication and behavior pattern is affected due to mental and developmental conditions is on the rise. Most of these conditions develop to uncontrollable levels because of ignorance and unaware about their child’s condition. The many myths surrounding mental or developmental conditions are a major cause of families of affected children to develop bitterness and to shy off from seeking appropriate help in time. Several early intervention programs have been put in place, and the number of beneficiaries of these programs is increasing by the day. This research seeks to look into early intervention programs and their effectiveness. The purpose of this study was to investigate the effect of early therapeutic intervention for the children with autism spectrum disorder. Participants were 140 children with autism spectrum disorder from Autism Corner in a selected rehabilitation center of Bangladesh. This study included children who are at age of 18-month to 36-month and who were taking occupational therapy and speech and language therapy from the autism center. They were primarily screened using M-CHAT; however, children with other physical disability or medical conditions excluded. 3-months interventions of 6 sessions per week are a minimum of 45-minutes long per session, one to one interaction followed by parent-led structured home-based therapy were provided. The results indicated that early intensive therapeutic intervention improve understanding, social skills and sensory skills. It can be concluded that therapeutic early intervention a positive effect on diminishing symptoms of Autism Spectrum Disorder.

Keywords: M-CHAT, ASD, sensory cheeklist, OT

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28667 Rural Tourism in Indian Himalayan Region: A Scope for Sustainable Livelihood

Authors: Rommila Chandra, Harshika Choudhary

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The present-day tourism sector is globally developing at a fast pace, searching for new ideas and new venues. In the Indian Himalayan Region (IHR), tourism has experienced a vast growth and continuous diversification over the last few years, thus becoming one of the fastest-growing economic sectors in India. With its majestic landscape, high peaks, rich floral and faunal diversity, and cultural history, the IHR has continuously attracted tourists and pilgrims from across the globe. The IHR has attracted a vast range of visitors who seek adventure sports, natural and spiritual solace, peace, cultural assets, food, and festivals, etc. Thus, the multi-functionality of the region has turned tourism into a key component of economic growth for the rural communities in the hills. For the local mountain people, it means valuable economic opportunity for income generation, and for the government and entrepreneurs, it brings profits. As the urban cities gain attention and investment in India, efforts have to be made to protect, safeguard, and strengthen the cultural, spiritual, and natural heritage of IHR for sustainable livelihood development. Furthermore, the socio-economic and environmental insecurities, along with geographical isolation, adds to the challenging survival in the tough terrains of IHR, creating a major threat of outmigration, land abandonment, and degradation. The question the paper intends to answer is: whether the rural community of IHR is aware of the new global trends in rural tourism and the extent of their willingness to adapt to the evolving tourism industry, which impacts the rural economy, including sustainable livelihood opportunity. The objective of the paper is to discuss the integrated nature of rural tourism, which widely depends upon natural resources, cultural heritage, agriculture/horticulture, infrastructural development, education, social awareness, and willingness of the locals. The sustainable management of all these different rural activities can lead to long-term livelihood development and social upliftment. It highlights some gap areas and recommends fewcommunity-based coping measures which the local people can adopt amidst the disorganized sector of rural tourism. Lastly, the main contribution is the exploratory research of the rural tourism vulnerability in the IHR, which would further help in studying the resilience of the tourism sector in the rural parts of a developing nation.

Keywords: community-based approach, sustainable livelihood development, Indian Himalayan region, rural tourism

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28666 Assessing the Efficiency of Pre-Hospital Scoring System with Conventional Coagulation Tests Based Definition of Acute Traumatic Coagulopathy

Authors: Venencia Albert, Arulselvi Subramanian, Hara Prasad Pati, Asok K. Mukhophadhyay

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Acute traumatic coagulopathy in an endogenous dysregulation of the intrinsic coagulation system in response to the injury, associated with three-fold risk of poor outcome, and is more amenable to corrective interventions, subsequent to early identification and management. Multiple definitions for stratification of the patients' risk for early acute coagulopathy have been proposed, with considerable variations in the defining criteria, including several trauma-scoring systems based on prehospital data. We aimed to develop a clinically relevant definition for acute coagulopathy of trauma based on conventional coagulation assays and to assess its efficacy in comparison to recently established prehospital prediction models. Methodology: Retrospective data of all trauma patients (n = 490) presented to our level I trauma center, in 2014, was extracted. Receiver operating characteristic curve analysis was done to establish cut-offs for conventional coagulation assays for identification of patients with acute traumatic coagulopathy was done. Prospectively data of (n = 100) adult trauma patients was collected and cohort was stratified by the established definition and classified as "coagulopathic" or "non-coagulopathic" and correlated with the Prediction of acute coagulopathy of trauma score and Trauma-Induced Coagulopathy Clinical Score for identifying trauma coagulopathy and subsequent risk for mortality. Results: Data of 490 trauma patients (average age 31.85±9.04; 86.7% males) was extracted. 53.3% had head injury, 26.6% had fractures, 7.5% had chest and abdominal injury. Acute traumatic coagulopathy was defined as international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s. Of the 100 adult trauma patients (average age 36.5±14.2; 94% males), 63% had early coagulopathy based on our conventional coagulation assay definition. Overall prediction of acute coagulopathy of trauma score was 118.7±58.5 and trauma-induced coagulopathy clinical score was 3(0-8). Both the scores were higher in coagulopathic than non-coagulopathic patients (prediction of acute coagulopathy of trauma score 123.2±8.3 vs. 110.9±6.8, p-value = 0.31; trauma-induced coagulopathy clinical score 4(3-8) vs. 3(0-8), p-value = 0.89), but not statistically significant. Overall mortality was 41%. Mortality rate was significantly higher in coagulopathic than non-coagulopathic patients (75.5% vs. 54.2%, p-value = 0.04). High prediction of acute coagulopathy of trauma score also significantly associated with mortality (134.2±9.95 vs. 107.8±6.82, p-value = 0.02), whereas trauma-induced coagulopathy clinical score did not vary be survivors and non-survivors. Conclusion: Early coagulopathy was seen in 63% of trauma patients, which was significantly associated with mortality. Acute traumatic coagulopathy defined by conventional coagulation assays (international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s) demonstrated good ability to identify coagulopathy and subsequent mortality, in comparison to the prehospital parameter-based scoring systems. Prediction of acute coagulopathy of trauma score may be more suited for predicting mortality rather than early coagulopathy. In emergency trauma situations, where immediate corrective measures need to be taken, complex multivariable scoring algorithms may cause delay, whereas coagulation parameters and conventional coagulation tests will give highly specific results.

Keywords: trauma, coagulopathy, prediction, model

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28665 Variation in Maternal Mortality in Sidama National Regional State, Southern Ethiopia: A Population Based Cross Sectional Household Survey

Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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28664 Climate Change Impact on Slope Stability: A Study of Slope Drainage Design and Operation

Authors: Elena Mugarza, Stephanie Glendinning, Ross Stirling, Colin Davies

Abstract:

The effects of climate change and increased rainfall events on UK-based infrastructure are observable, with an increasing number being reported on in the national press. The fatal derailment at Stonehaven in 2020 prompted a wider review of Network Rail-owned earthworks assets. The event was indicated by the Rail Accident Investigation Branch (RAIB) to be caused by mis-installed drainage on the adjacent cutting. The slope failure on Snake Pass (public highway A57) was reportedly caused by significant water ingress following numerous storm events and resulted in the road’s closure for several months. This problem is only projected to continue with greater intensity and more prolonged rainfall events forecasted in the future. Subsequently, this project is designed to evaluate effective drainage trench design within infrastructure embankments, considering the capillary barrier phenomenon that may govern their deterioration and resultant failure. Theoretically, the differential between grain sizes of the embankment clays and gravels, customarily used in drainage trenches, would have a limiting effect on infiltration. As such, it is anticipated that the inclusion of an additional material with an intermediate grain size should improve the hydraulic conductivity across the drainage boundary. Multiple drainage designs will be studied using instrumentation within the drain and surrounding clays. Data from the real-world installation at the BIONICS embankment will be collected and compared with laboratory and Finite Element (FE) simulations. This research aims to reduce the risk of infrastructure slope failures by improving the resilience of earthwork drainage and lessening the consequential impact on transportation networks.

Keywords: earthworks, slope drainage, transportation slopes, deterioration, capillary barriers, field study

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